Opioid Painkillers Ineffective For Chronic Pain


According to the American Academy of Neurology, opioid painkillers are ineffective long-term for people suffering from chronic pain. Chronic pain sufferers with conditions not related to cancer, like fibromyalgia, destructive rheumatoid arthritis, severe neuropathic pain and  sickle-cell disease who take opioid painkillers are more likely to overdose or become addicted than improve their ability to function.

The American Academy of Neurology warned that doctors who prescribe these powerful medications should carefully monitor any increases in dosages, screen for depression, and prudently look for signs of substance abuse or misuse. The neurology group released a comprehensive set of guidelines for physicians that outlines what types of patients would benefit most from long-term opioid use. The guidelines also list what practices a doctor should follow before prescribing this type of medication.

The paper also recommended that a doctor who prescribes opioid medication for long-term use should make a written opioid treatment agreement that outlines the responsibilities of both the patient and the doctor. Physicians need to track dose increases and monitor function levels. If a patient reaches a certain dosage level and there in no increase in improvement, the doctor should then seek out the help of a pain specialist.

The position paper also recommended that doctors should not prescribe any sedative drugs along with opioid painkillers. Random urine testing is also recommended to screen for potential misuse and abuse of these powerful medications. If a patient has taken opioid painkillers for longer than three months and has unusual behavior or history of overdose, then the physician should begin weaning the patient off the medication as it is ineffective on a longer term, for the patient’s chronic pain.

The guidelines were published in a position paper on Wednesday in the journal Neurology. The paper notes that although painkiller addiction has claimed over 100,000 lives in the last ten years, many of the practices and laws that were put in place in the late 1990s remain the same. The paper also added that the on-line databases that doctors use to monitor controlled substances prescribed to a patient are underutilized, underfunding, and inoperable across state lines or other health care systems.

These inadequacies of the on-line databases allow for the ability for the patient’s tolerance and need for higher dosages to go unnoticed. The result is not only substance abuse and addiction, but an increasing risk of accidental overdose. Opioid narcotics depress a patient’s breathing, and if the patients mixes the narcotic with alcohol or any other sedative, it can prove to be deadly. The age group at most risk is that of patients between the ages of 35 and 54. Accidental overdose resulting in death is more fatal than firearms or motor vehicle crashes.

The paper released by the American Academy of Neurology cited studies that showed almost half of patients who were taking opioid medication for approximately three months were still on those medications five years later. The research also showed that in many cases the patient’s dosages were increased but their level of function did not increase. This is further proof that other alternatives for chronic pain management need to be considered, as the opiod painkillers prove themselves to be ineffective for the patient.

By Valerie Bordeau


The Los Angeles Times Science/Science Now
Psychology Today

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